Surgery for Acromegaly | Treatment

Having surgery to remove the tumour, or as much as possible, is often the first step in treating acromegaly.1

There are several things that will increase the chance of success of surgery:1

Growth hormone levels below 45 ng/mL (ng/mL is the unit of measurement) before surgery
A tumour that is no bigger than 10 mm in diameter (across)
A tumour that isn't too close to other key structures in the brain, such as the nerves supplying the eyes or nearby blood vessels

However, if your tumour is too large to be completely removed, you may still have surgery to improve your symptoms. Reducing the size of the tumour can reduce the amount of growth hormone being released, relieve pressure that may be causing headaches1 and make sure the tumour and surrounding area is suitable for treatment with radiotherapy.2

How is acromegaly surgery performed?

The pituitary gland is very small, and sits at the base of the brain, in the middle of your skull.3 To reach it, the surgeon doesn’t have to go through the skull, but can make a small cut in the back of your nose.3 Special instruments are then used to remove the tumour.3 The whole operation should take about an hour.3

If all of the tumour has been removed, you may begin to see improvement in your symptoms in only a few days, including changes in your facial features.3 However, sometimes, even if the levels of growth hormone released by the tumour have been reduced, you may need to have additional treatment with drug therapy.3

Having any type of surgery has some risks, and may lead to complications. Your surgeon will explain the risks of surgery to you beforehand.

REFERENCES:

Endocrine Web. Acromegaly surgery. Available at:
https://www.endocrineweb.com/conditions/acromegaly/acromegaly-surgery Last accessed September 2020.
Bollerslev J et al. Individualised management of acromegaly. Eur J Endocin. 2019;181:R1-R15.
The Pituitary Society. Treatment of acromegaly. Available at:
+https://www.pituitarysociety.org/patient-education/pituitary-disorders/acromegaly/treatment-of-acromegaly. Last accessed September 2020.